Insights on the paleoepidemiology of ancient tuberculosis from the structural analysis of postcranial remains from the Ligurian Neolithic (northwestern Italy)

Abstract

Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. Abstract: The aim of this research was to gain insights on the timeline of progression of osteoarticular tuberculosis (TB) in people from the Neolithic period by using skeletal traits that are independent of the bony lesions. The body proportions and postcranial mechanical strength of bones from two individuals from Liguria in northwestern Italy (Arene Candide 5, adolescent, and Arma dell'Aquila 1, adult), were compared with the rest of the Ligurian Neolithic skeletal series (45 individuals). If TB led to wasting of the skeleton and lack of normal function which endured for years, as often happens today, a clear signature of postcranial gracility and disruption of development should be apparent. Conversely, rapid progress of the disease would leave little systemic macroscopic change in the skeleton, except for the bony lesions directly caused by the TB pathogen, suggesting a different level of bacterial virulence in the past. The extreme biomechanical gracility observed in the lower limb of Arene Candide 5 suggests a period of compromised diaphyseal periosteal apposition during ontogeny due to metabolic disturbances likely linked to TB. Results suggest that, in Neolithic Liguria, TB in humans saw a slow, chronic progression, which is characteristic of diseases with long histories of host-pathogen coevolution. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64

Multi-proxy stable isotope analyses of dentine microsections reveal diachronic changes in life history adaptations, mobility, and tuberculosis-induced wasting in prehistoric Liguria (Finale Ligure, Italy, northwestern Mediterranean)

“…An isotopic signal of TB-induced 'consumption' was expected in this individual (Macallan, 1999;Schwenk and Macallan, 2000;del Rey et al, 2007), and its onset appears to be consistent with previous estimates of active TB duration, c. 2-3 years, based on skeletal gracilization and enamel hypoplasia (Formicola et al, 1987;Sparacello et al, 2016). This finding appears to confirm that by the SMP Neolithic period, TB had become a slow, chronic condition, characteristic of diseases with a long history of hostpathogen coevolution (Sparacello et al, 2016).…”

“…However, our small sample and its composition does not allow the determination of optimal weaning strategies for survivorship in the local ecology of Neolithic Liguria. The individual with the smoothest dentine profile in our sample, Arene Candide V, died at the age of c. 15 years, potentially due to osteoarticular tuberculosis and displays evidence of growth faltering both in stature and long bone cortical development (Sparacello et al, 2016;Dori et al, 2019).…”

“…In fact, the Neolithic skeletal series in the Finalese area are known for having yielded several cases of osteoarticular tuberculosis (TB; Canci et al, 1996;Formicola et al, 1987;Sparacello et al, 2017Sparacello et al, , 2018; see also Dori et al, 2019). Tuberculosis is a highly infectious, debilitating, and growth-impairing disease (Sparacello et al, 2016). One of the Neolithic individuals included in this study is Arene Candide V (excavations Bernabò-Brea and Cardini; Bernabò Brea, 1946), an adolescent who died with Pott's spine, a skeletal lesion that is pathognomonic of osteoarticular tuberculosis (Formicola et al, 1987).…”

“…The study of Arene Candide V will also provide information on the course of TB in this individual and will contribute to the debate on TB virulence and host-pathogen co-evolution in the Neolithic (Sparacello et al, 2016). Tuberculosis causes severe metabolic disturbances (cytokine activation, abnormal protein metabolism, and hormonal unbalance) causing 'consumption' (Macallan, 1999;Schwenk and Macallan, 2000;del Rey et al, 2007).…”

“…During such catabolic states, individuals use amino acids from their own body tissues to synthesize new proteins, resulting in an increase of δ 15 N values (Beaumont et al, 2013;Beaumont and Montgomery, 2016;Katzenberg and Lovell, 1999). Tracing the onset of this "pathological trophic shift" will test the previous estimates of active TB duration in this individual, c. 2-3 years, based on skeletal gracilization and enamel hypoplasia (Formicola et al, 1987;Sparacello et al, 2016).…”